Characterisation of neonatal seizures and their treatment using continuous EEG monitoring: a multicentre experience

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dc.contributor.authorRennie, Janet M.
dc.contributor.authorde Vries, Linda S.
dc.contributor.authorBlennow, Mats
dc.contributor.authorForan, Adrienne
dc.contributor.authorShah, Divyen K.
dc.contributor.authorLivingstone, Vicki
dc.contributor.authorvan Huffelen, Alexander C.
dc.contributor.authorMathieson, Sean R.
dc.contributor.authorPavlidis, Elena
dc.contributor.authorWeeke, Lauren C.
dc.contributor.authorToet, Mona C.
dc.contributor.authorFinder, Mikael
dc.contributor.authorPinnamaneni, Raga Mallika
dc.contributor.authorMurray, Deirdre M.
dc.contributor.authorRyan, Anthony C.
dc.contributor.authorMarnane, William P.
dc.contributor.authorBoylan, Geraldine B.
dc.contributor.funderScience Foundation Irelanden
dc.contributor.funderWellcome Trusten
dc.date.accessioned2019-06-26T17:00:15Z
dc.date.available2019-06-26T17:00:15Z
dc.date.issued2018-11-24
dc.description.abstractObjective The aim of this multicentre study was to describe detailed characteristics of electrographic seizures in a cohort of neonates monitored with multichannel continuous electroencephalography (cEEG) in 6 European centres.Methods Neonates of at least 36 weeks of gestation who required cEEG monitoring for clinical concerns were eligible, and were enrolled prospectively over 2 years from June 2013. Additional retrospective data were available from two centres for January 2011 to February 2014. Clinical data and EEGs were reviewed by expert neurophysiologists through a central server.Results Of 214 neonates who had recordings suitable for analysis, EEG seizures were confirmed in 75 (35%). The most common cause was hypoxic-ischaemic encephalopathy (44/75, 59%), followed by metabolic/genetic disorders (16/75, 21%) and stroke (10/75, 13%). The median number of seizures was 24 (IQR 9–51), and the median maximum hourly seizure burden in minutes per hour (MSB) was 21 min (IQR 11–32), with 21 (28%) having status epilepticus defined as MSB>30 min/hour. MSB developed later in neonates with a metabolic/genetic disorder. Over half (112/214, 52%) of the neonates were given at least one antiepileptic drug (AED) and both overtreatment and undertreatment was evident. When EEG monitoring was ongoing, 27 neonates (19%) with no electrographic seizures received AEDs. Fourteen neonates (19%) who did have electrographic seizures during cEEG monitoring did not receive an AED.Conclusions Our results show that even with access to cEEG monitoring, neonatal seizures are frequent, difficult to recognise and difficult to treat.Oberservation study number NCT02160171.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid24en
dc.identifier.citationRennie, J.M., de Vries, L.S., Blennow, M., Foran, A., Shah, D.K., Livingstone, V., van Huffelen, A.C., Mathieson, S.R., Pavlidis, E., Weeke, L.C. and Toet, M.C., 2018. Characterisation of neonatal seizures and their treatment using continuous EEG monitoring: a multicentre experience. Archives of Disease in Childhood-Fetal and Neonatal Edition, 24, (9pp) DOI: 10.1136/archdischild-2018-315624en
dc.identifier.doi10.1136/archdischild-2018-315624en
dc.identifier.eissn1468-2052
dc.identifier.endpage9en
dc.identifier.issn1359-2998
dc.identifier.journaltitleArchives of Disease in Childhood - Fetal and Neonatal Editionen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/8107
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.relation.projectinfo:eu-repo/grantAgreement/WT/Technology Transfer Division/098983//Multicentre Clinical evaluation of a neonatal seizure detection algorithm./en
dc.relation.projectinfo:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/en
dc.relation.urihttps://fn.bmj.com/content/early/2018/11/24/archdischild-2018-315624
dc.rights© Author(s) (or their employer(s)) 2018. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectNeonatal seizuresen
dc.subjectElectroencephalographyen
dc.subjectAntiepilepticen
dc.subjectEEG monitoringen
dc.titleCharacterisation of neonatal seizures and their treatment using continuous EEG monitoring: a multicentre experienceen
dc.typeArticle (peer-reviewed)en
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